29th May 2023

Management

This is highly individualised and takes into account the severity of MDS, patient age and fitness for treatment. Elderly patients with low risk MDS are more likely to die with MDS than from it.

1. The only truly curative option for MDS is high dose chemotherapy, usually supported by allogeneic stem cell transplant. This option is reserved for high risk MDS and only in those fit enough.
2. Lower intensity chemotherapy such as azacytidine or lenalidomide
3. Supportive therapy
   1. Blood and platelet transfusions
   2. Growth factor support
   3. Antibiotics as necessary

Patients receiving regular transfusions of RBC are at risk for transfusion-associated iron overload and may require iron chelation therapy.